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Cell-based therapy to reduce mortality from COVID-19: Systematic review and meta-analysis of human studies on acute respiratory distress syndrome.
Stem Cells Transl Med. 2020 09; 9(9):1007-1022.SC

Abstract

Severe cases of COVID-19 infection, often leading to death, have been associated with variants of acute respiratory distress syndrome (ARDS). Cell therapy with mesenchymal stromal cells (MSCs) is a potential treatment for COVID-19 ARDS based on preclinical and clinical studies supporting the concept that MSCs modulate the inflammatory and remodeling processes and restore alveolo-capillary barriers. The authors performed a systematic literature review and random-effects meta-analysis to determine the potential value of MSC therapy for treating COVID-19-infected patients with ARDS. Publications in all languages from 1990 to March 31, 2020 were reviewed, yielding 2691 studies, of which nine were included. MSCs were intravenously or intratracheally administered in 117 participants, who were followed for 14 days to 5 years. All MSCs were allogeneic from bone marrow, umbilical cord, menstrual blood, adipose tissue, or unreported sources. Combined mortality showed a favorable trend but did not reach statistical significance. No related serious adverse events were reported and mild adverse events resolved spontaneously. A trend was found of improved radiographic findings, pulmonary function (lung compliance, tidal volumes, PaO2 /FiO2 ratio, alveolo-capillary injury), and inflammatory biomarker levels. No comparisons were made between MSCs of different sources.

Authors+Show Affiliations

Department of Pain Medicine, Mayo Clinic, Jacksonville, Florida, USA. Center for Regenerative Medicine, Mayo Clinic, Jacksonville, Florida, USA.Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery , Mayo Clinic, Rochester, Minnesota, USA.Interdisciplinary Stem Cell Institute and Cardiology Division, Department of Medicine, University of Miami, Miller School of Medicine, Miami, Florida, USA.Center for Regenerative Medicine, Mayo Clinic, Jacksonville, Florida, USA. Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA.Division of Pulmonary, Allergy and Sleep Medicine, Department of Medicine, Mayo Clinic, Jacksonville, Florida, USA.Division of Pulmonary, Allergy and Sleep Medicine, Department of Medicine, Mayo Clinic, Jacksonville, Florida, USA.Skeletal Research Center, Biology Department, Case Western Reserve University, Cleveland, Ohio, USA.Marcus Center for Cellular Cures, Duke University Medical Center, Durham, North Carolina, USA.Center for Regenerative Medicine, Mayo Clinic, Jacksonville, Florida, USA. Transfusion Medicine and Stem Cell Therapy, Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, Florida, USA.Department of Physical Medicine and Rehabilitation, Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.Department of Pain Medicine, Mayo Clinic, Jacksonville, Florida, USA.Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery , Mayo Clinic, Rochester, Minnesota, USA.Department of Preventative, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota, USA.Department of Preventative, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota, USA.Department of Preventative, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota, USA.Mayo Clinic Library, Rochester, Minnesota, USA.Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery , Mayo Clinic, Rochester, Minnesota, USA. Department of Preventative, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota, USA.Department of Pathology and Laboratory Medicine, Department of Health Policy and Management, Rollins School of Public Health, Emory University, The Marcus Foundation, Atlanta, Georgia, USA.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

32472653

Citation

Qu, Wenchun, et al. "Cell-based Therapy to Reduce Mortality From COVID-19: Systematic Review and Meta-analysis of Human Studies On Acute Respiratory Distress Syndrome." Stem Cells Translational Medicine, vol. 9, no. 9, 2020, pp. 1007-1022.
Qu W, Wang Z, Hare JM, et al. Cell-based therapy to reduce mortality from COVID-19: Systematic review and meta-analysis of human studies on acute respiratory distress syndrome. Stem Cells Transl Med. 2020;9(9):1007-1022.
Qu, W., Wang, Z., Hare, J. M., Bu, G., Mallea, J. M., Pascual, J. M., Caplan, A. I., Kurtzberg, J., Zubair, A. C., Kubrova, E., Engelberg-Cook, E., Nayfeh, T., Shah, V. P., Hill, J. C., Wolf, M. E., Prokop, L. J., Murad, M. H., & Sanfilippo, F. P. (2020). Cell-based therapy to reduce mortality from COVID-19: Systematic review and meta-analysis of human studies on acute respiratory distress syndrome. Stem Cells Translational Medicine, 9(9), 1007-1022. https://doi.org/10.1002/sctm.20-0146
Qu W, et al. Cell-based Therapy to Reduce Mortality From COVID-19: Systematic Review and Meta-analysis of Human Studies On Acute Respiratory Distress Syndrome. Stem Cells Transl Med. 2020;9(9):1007-1022. PubMed PMID: 32472653.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cell-based therapy to reduce mortality from COVID-19: Systematic review and meta-analysis of human studies on acute respiratory distress syndrome. AU - Qu,Wenchun, AU - Wang,Zhen, AU - Hare,Joshua M, AU - Bu,Guojun, AU - Mallea,Jorge M, AU - Pascual,Jorge M, AU - Caplan,Arnold I, AU - Kurtzberg,Joanne, AU - Zubair,Abba C, AU - Kubrova,Eva, AU - Engelberg-Cook,Erica, AU - Nayfeh,Tarek, AU - Shah,Vishal P, AU - Hill,James C, AU - Wolf,Michael E, AU - Prokop,Larry J, AU - Murad,M Hassan, AU - Sanfilippo,Fred P, Y1 - 2020/05/29/ PY - 2020/04/08/received PY - 2020/04/27/revised PY - 2020/05/03/accepted PY - 2020/5/31/pubmed PY - 2020/9/12/medline PY - 2020/5/31/entrez KW - COVID-19 KW - acute respiratory distress syndrome KW - mesenchymal stromal cells KW - mortality KW - systematic review SP - 1007 EP - 1022 JF - Stem cells translational medicine JO - Stem Cells Transl Med VL - 9 IS - 9 N2 - Severe cases of COVID-19 infection, often leading to death, have been associated with variants of acute respiratory distress syndrome (ARDS). Cell therapy with mesenchymal stromal cells (MSCs) is a potential treatment for COVID-19 ARDS based on preclinical and clinical studies supporting the concept that MSCs modulate the inflammatory and remodeling processes and restore alveolo-capillary barriers. The authors performed a systematic literature review and random-effects meta-analysis to determine the potential value of MSC therapy for treating COVID-19-infected patients with ARDS. Publications in all languages from 1990 to March 31, 2020 were reviewed, yielding 2691 studies, of which nine were included. MSCs were intravenously or intratracheally administered in 117 participants, who were followed for 14 days to 5 years. All MSCs were allogeneic from bone marrow, umbilical cord, menstrual blood, adipose tissue, or unreported sources. Combined mortality showed a favorable trend but did not reach statistical significance. No related serious adverse events were reported and mild adverse events resolved spontaneously. A trend was found of improved radiographic findings, pulmonary function (lung compliance, tidal volumes, PaO2 /FiO2 ratio, alveolo-capillary injury), and inflammatory biomarker levels. No comparisons were made between MSCs of different sources. SN - 2157-6580 UR - https://www.unboundmedicine.com/medline/citation/32472653/Cell_based_therapy_to_reduce_mortality_from_COVID_19:_Systematic_review_and_meta_analysis_of_human_studies_on_acute_respiratory_distress_syndrome_ L2 - https://doi.org/10.1002/sctm.20-0146 DB - PRIME DP - Unbound Medicine ER -